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Archive January 2022

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AHCA/NCAL CEO Parkinson Named "Most Influential"

Mark Parkinson, President and CEO of American Health Care Association/National Center for Assisted Living (AHCA/NCAL) is one of Modern Healthcare’s “100 Most Influential People in Healthcare”  for 2021. This is Parkinson’s second consecutive year on the list. 
 
Parkinson was recognized for his efforts leading the charge to “fund and protect the 14,000 skilled-nursing facilities and assisted-living centers his organization represents during the pandemic.” 
 
According to Parkinson, “The key is for leadership to not panic. Instead, we need to assess the real damage, what can be done to repair it and develop a plan to move forward. Leaders who articulate that plan, work it and stay steady while reassuring their team that there is a way out will shine during a crisis.” 



Parkinson was previously the governor of Kansas as well as owner/operator of multiple long term care facilities. He also appeared on the list in 2015.

Staff contact: ngrosso@mehca.org

 

REMINDER: MEMA PPE/Testing Supply Requests

Today the Maine Emergency Management Agencies put out a notice stating that they have been receiving an increasing number of PPE/COVID testing supply requests in recent weeks with the uptick in COVID19 cases.  As I'm sure you already know the CDC has taken over all PPE/testing supply orders since July 21st 2021. To remedy any confusion, please follow the steps below:
 
Below is a downloadable "form link" for your facility to submit a resource request(s) for Personal Protective Equipment or COVID19 Testing supplies.
 
A separate order will need to be created when ordering both PPE and Testing supplies.
The link to that form is
https://www.maine.gov/dhhs/mecdc/public-health-systems/phep/information.shtml
 
CDC is using a tiered process to allocate limited PPE resources as they are requested.
 
We would highly encourage you to continue looking for PPE/Testing supply vendors as well. 
 
Please send your completed form(s) to
PPEorC19TestingSupplies.MECDC@maine.gov
 
Additionally we would recommend visiting the below
webpage to stay informed on COVID19 response efforts.
 
Staff Contact: 
dwatford@mehca.org

CMS Release NEW FAQ on Visitation Guidelines

The Centers for Medicare and Medicaid Services (CMS) issued a new set of Frequently Asked Questions (FAQs) on the revised nursing home visitation guidelines, outlined in memo QSO-20-39-NH REVISED. As you know, MHCA continues to advocate with Maine DHHS for clarity and flexibility on the most recent visitation guidance, particularly as the Omicron variant surges. Below are the highlights in CMS’s four-page FAQs. We encourage providers to read the document in its entirety.

Visitations must be allowed, but your state or local health department can restrict visitations during an infectious disease outbreak. You should also pause admissions if this happens.
  • Facilities must notify their state or local health department per CDC guidelines if:
    • One or more residents or staff with suspected or confirmed COVID-19 infection;
    • Resident with severe respiratory infection resulting in hospitalization or death;
    • Three or more residents or staff with acute illness compatible with COVID-19 within a 72- hour period.
You can limit large gatherings and develop a schedule for visitation IF social distancing cannot be maintained. However, these strategies should only be employed when a high volume of visitors are expected.

You must require visitors to follow infection control practices, such as the use of source control masks, while in the building and communal areas.

During visits, residents have the right (not visitors) to decide if visitors will remove their mask or decide to not follow other core infection control practices (e.g., social distancing). We recommend you discuss what practices are followed and who they want to visit with your residents, or their representatives. Make note of resident wishes regarding:
  • The vaccination status of visitors. Note that residents can refuse to have visitors who are unvaccinated.
  • Use of masks and personal protective equipment (PPE) while in their room. Note that residents can require visitors to wear masks and maintain social distancing during the visit.
  • You can also inform visitors of the risk to themselves and the resident should they decide not to follow the use of masks and other core infection control practices while in a resident’s room during a visit.
  • Visits among residents who have roommates should ideally occur in a separate space or when the roommate(s) are out of the room. If this is not possible, an in-room visit can occur if social distancing and use of source control masks are followed.
Staff Contact: dwatford@mehca.org

MHCA Wage & Fringe Benefit Survey sent out - please complete by February 2

On Monday, January 3, the survey was emailed directly to administrators, as well as human resource and business office managers whose email addresses we have on file. MHCA has modified the timeline for completing the annual Wage & Fringe Benefit survey to better align with our advocacy efforts at the Maine Legislature. The legislative session begins this week and we expect workforce recruitment and retention to remain prominent issues. As such, your input is vital and we ask you to please complete and return the survey to MHCA by February 2, 2022. As always, individual responses will remain confidential. 
 
If you need a copy of the survey sent to you (or other staff member), please contact Dianne at the Association office (207.623.1146, ext. 201)
 
Staff Contact: dchicoine@mehca.org

Welcome New Member!

Join us in welcoming The Heron House, 92 US Route 1, Cumberland Foreside, ME 04110-1315. The Heron House is a 24-bed Level IV Residential Care Facility (former d/b/a Ledgeview Assisted Living). Nichole Lessard is the Administrator.
 
Staff Contact: dchicoine@mehca.org

Join the Maine Dementia Care Partnership for a FREE educational opportunity!

The Maine Dementia Care Partnership (MDCP) is pleased to present the free, virtual education program, Addressing Root Causes of Cognitive Decline: A Guide to Preventing and Reducing Antipsychotics and How a New Maine Dementia Care Toolkit Can Help, on February 8 & 15, 2022, from 1-4 pm. The same program is being offered on two different dates to allow participants to choose the session that works best for them.
 
Part one of the session welcomes back popular speaker, Eric Collett, from A Mind for All Seasons, who will share current brain research that allows us to understand many of the root causes of cognitive decline and intervene to help people function better. This insightful presentation will help you understand the steps you can begin taking today to help those you serve exhibit improved behavior patterns by improving their cognitive functioning.
 
Part two of the program will introduce the Partnership’s new resident-centered dementia care toolkit. The “Is it for me, or for you?” Resident-Centered Dementia Care Toolkit is the result of many months of grant-funded work by Partnership members and clinicians. It provides a conceptual framework, roadmap, and step-by-step guide to help nursing homes successfully reduce off-label antipsychotic drug use within their settings. It includes strategies for educating and collaborating with various constituencies, fostering community wide commitment to reducing A/P utilization, using data to inform decision making, developing dementia care competencies for staff, and identifying specific individuals for gradual dose reduction.
 
As a requirement of the grant funding, the Partnership will engage at least 40 nursing homes in a formalized effort to implement at least one toolkit item. Interested providers will sign a letter of agreement and receive targeted support from Partnership members as they embark on their chosen project. The toolkit will be distributed free of charge to every Maine nursing home.
 
To view the flyer,
please click here
To register your team,
please click here
 
Please reach out to me in the association office at (207) 623-1146 with any questions.

Staff Contact: ngrosso@mehca.org 

Notes from ME DHHS Medical Directors Call 1/4/2022

Below are remarks and resources shared during the 1/4/22 Medical Director's call with the ME CDC and DHHS, as well as the Q&A’s that were discussed on the call:  Note recent ME CDC HAN summarizing available COVID therapeutics, posted this week on ME CDC website: https://www.maine.gov/dhhs/mecdc/newhan.shtml

Q: It was my understanding a person who tested positive for COVID could continue to test positive for up to 90 days.  Is this still accurate?
A: Yes, on PCR testing (not rapid Ag testing)
 
Q: Would you recommend pooled testing for staff regardless of vaccination status? 
A: Yes - even those who are vaccinated are susceptible, particularly to the omicron variant
 
Q: I have reviewed the HCW Exposure Guidance decision tree. If asymptomatic High Risk Exposure for HCW, it says to test immediately. Should this test be a PCR or is an antigen test OK?
A: Either an antigen test or Nucleic Acid Amplification Tests (NAAT) such as PCR can be used. Some people may be beyond the period of expected infectiousness but remain NAAT positive for an extended period. Antigen tests typically have a more rapid turnaround time but are often less sensitive than NAAT. Antigen testing is preferred for symptomatic HCP and for asymptomatic HCP who have recovered from SARS-CoV-2 infection in the prior 90 days.
 
Q: Is anyone using antigen testing on residents to release them from quarantine?
A: Testing should not be used to shorten quarantine
 
Q: Can we NOT do PCR confirmation of an antigen test?
A: PCR testing is not routinely needed to confirm a positive antigen test, particularly if the individual is symptomatic and/or is a known close contact of someone with acute COVID infection
 
Q: If a person has been positive in the past 90 days and is now symptomatic- do you recommend PCR and NOT antigen?
A: PCR testing is always preferred when available
 
Q: Would you treat an exposed (but test negative) roommate with COVID antivirals or monoclonals?
A: COVID antivirals (i.e. Paxlovid & molnupiravir) can only be used for symptomatic patients, and not for COVID post-exposure prophlyaxis (PEP).  Some monoclonals can be used for PEP (REGEN-COV & bam-ete), but that is changing as use of those two monoclonals is not recommended for PEP or COVID treatment once we are at >80% omicron prevalence in the state.
 
Q: What labs, if any, should be checked prior to administration of oral antivirals?
A: Providers should consult the FDA EUA Provider Health Care Fact Sheets for specifics on use these new medications:
Paxlovid Provider Fact Sheet and Molnupiravir Provider Fact Sheet
 
Q: Is there any guidance regarding getting a booster if you have had a possible exposure to COVID?
A: US CDC advises that all adults get a COVID booster as soon as possible; the only time not to get a booster is while an individual is acutely infected with COVID and in their isolation period (and that is primarily to protect others around them from being exposed).
 
Q: What pharmacies are carrying the COVID antivirals?
A: The state is distributing its very limited supplies of Paxlovid & molnupiravir at a subset of Walmart & Hannaford pharmacies.  You can search Walmart website to find store nearest you that is carrying oral anti-virals:
https://www.walmart.com/cp/2766660
 
Q: At this time are we able to follow Federal CDC guidance and have an employee who tests positive for COVID return to work after 7 days rather than 10 if we obtain a negative test and other symptoms have improved and no fever within 24 hours?
A: The new updated guidance for Healthcare workers can be followed, the tools referenced on the HAI website reflect these changes. Take a look here:
https://www.maine.gov/dhhs/mecdc/infectious-disease/hai/resources.shtml

Staff Contact: dwatford@mehca.org

CDC updates isolation and quarantine recommendations for the public

CDC has updated isolation and quarantine recommendations for the public. These recommendations do not apply to healthcare personnel and do not supersede state, local, tribal, of territorial laws, rules, and regulations.
 
People with COVID-19 should isolate for 5 days and if they are asymptomatic or their symptoms are resolving (without fever for 24 hours), follow that by 5 days of wearing a mask when around others.
 
Recommendations for people who are exposed to COVID-19 are also updated. If you are unvaccinated or more than 6 months out from your second mRNA dose (or more than 2 months after the J&J vaccine) and you are not yet boosted, CDC recommends a quarantine for 5 days followed by strict mask use for an additional 5 days. If a 5-day quarantine is not feasible, it is imperative that an exposed person wear a well-fitting mask at all times when around others for 10 days after exposure.
 
People who have received their booster shot do not need to quarantine following an exposure but should wear a mask for 10 days after the exposure. For all those exposed, best practice would also include a test for COVID-19 at day 5 after exposure. If symptoms occur, individuals should immediately quarantine until a negative test confirms symptoms are not attributable to COVID-19.

Staff Contact: 
dwatford@mehca.org

OSHA comment deadline approaching: January 19, 2022

The final comment period on any aspect of the standard ending Jan. 19th, 2022 on the Occupational Safety and Health Administration’s COVID-19 vaccination and testing emergency temporary standard, which requires employees of companies with 100 or more workers to be vaccinated or undergo regular COVID-19 testing and wear a face covering.

The
standard was published in the Federal Register Nov. 5 and is intended as a proposal for a permanent standard, according to OSHA. The comment period for the standard was set to expire Dec. 6, but the time was extended by 45 days to Jan. 19 “to allow stakeholders additional time to review the ETS and collect information and data necessary for comment,” according to the Labor Department.

OSHA is only accepting written comments via
www.regulations.gov in docket number OSHA-2021-0007.

The agency is suspending enforcement of the rule until Jan. 10 due to uncertainty caused by court cases “so long as an employer is exercising reasonable, good faith efforts to come into compliance with the standard.”

Staff Contact: 
dwatford@mehca.org

Last chance to register for next week's educational program: Use of the Temporary Nurse Aide Program to assist with crisis staffing

Back by popular demand, MHCA will re-run the educational program “The time is now! Use of the Temporary Nurse Aide Program to assist with crisis staffing” next week, Thursday, January 13, 2022 from 1:00-2:30PM. 1.5 CEUs will be offered for those who attend the program in full. Please note, this is a repeat offering of the program presented in November. 

The Temporary Nurse Aide, authorized for use during staffing shortages by Maine Division of Licensing and Certification, gives CNA employers unprecedented hiring and training flexibilities in this notoriously difficult to fill role. Recently, DHHS sent out a memorandum that allows for the use of such individuals to count toward state staffing ratios. In addition, DHHS has allowed for staffing ratio waiver requests to assist in the transition of hospital patients to nursing homes across the state. This program will review the free AHCA temporary nurse aide program, provide a template policy, implementation guide and review the necessary steps to stay compliant utilizing this option.

For more information and to register please click here

Staff Contact: aellis@mehca.org 
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